| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.92 | $26.92 | $26.92 | |
Aetna
| Professional | $26.92 | $26.92 | $34.67 | |
BCBS
| Facility | $489.78 | $645.65 | $1,258.93 | |
BCBS
| Professional | $33.11 | $34.67 | $34.67 | |
Medica
| Facility | $25.12 | $43.65 | $58.88 | |
United
| Facility | $28.18 | $46.77 | $60.26 |